Reminiscence
PEDIATRIC DERMATOLOGY IN ANTIQUITY Part II. Roman Empire* SAMUEL X RADBILL, M.D. Honorary tibrarian. The College of Physicians of Philadelphia, Philadelphia, Pennsylvania
The Romans looked askance at doctors and doctoring. They depended on the Greeks for their medical lore. Nevertheless, several outstanding medical works appeared during the height of Imperial Rome which are classics and helped to advance medical science. The writings of Celsus, Pliny, Dioscorides, Soranus and Galen stand out in particular. Some inkling of dermatological conditions can also be discerned in the general literature of Rome. Thus, we learn from Plautus that in early Rome, which reeked with dirt, skin diseases were rife, since he affirmed that malignant ulcerations and eroding lesions spread among the people. Even cancer was known from earliest times. Cato (234-149 B.C.), mentioned it in his De Re Rustica and Ovid, contemporary of Celsus, aptly alluded to it by saying "and thus the incurable malignant cancer characteristically spreads far and wide."' We know that scabies was also widespread from the fact that in their efforts to protect themselves from illness the early Romans, who before they adopted Greek medicine worshipped innumerable gods of diseases, had among these a goddess of scabies. Greek medicine attacked the notion that there was a godling for every symptom, but the early Latins depended upon a troop of specializing gods to bring them health and good fortune. As there were gods for every ailment, so there were also doctors who specialized. There were those who
specialized in hernias, in fistulas, in the eyes, the ears and, dermatologically, there were doctors especially for the baths to which the Romans were so partial, and which were so essential a part of dermatological therapy. Up to the time of Cato, folk medicine used theurgy plus drugs; then the drugs gradually escaped from theurgy to attain the marvelous virtues of the Galenicals, which seemed scarcely less supernatural.' But scientific medicine came to Italy from the Greeks, and even Celsus, the first great compiler of medical knowledge, borrowed little from his own Latins. His treatise was wholly Greek in content. Yet, it was the first systematic medical treatise and had a great influence upon modern medicine. Wilh the invention of the printed text, it first appeared in print in 1478, 14 centuries after Celsus was gone, and has been reprinted at frequent intervals ever since.
Aurelius Cornelius Celsus (C.25 BC— c. 50 AD) Celsus lived about the time of Christ. Even though he was not a physician, he wrote a medical encyclopedia strikingly modern in concept and format, entirely free of sacerdotal or supernatural influences. Of particular interest to us here are the parts dealing with the skin that
* Part I appeared in |une 1975 14:363. Part III will appear in a future issue.
303
304
INTERNATIONAL JOURNAL OF DERMATOLOGY
are scattered throughout many sections of the work; chapter 28 of Book V is a full section devoted just to cutaneous inedicine." Here, among some 40 different dermatological conditions, we find many which are often encountered in infants and children. Indeed, even the well-known "area Celsi" (alopecia areata), occurs frequently in childhood. Favus, Latin for kerion—honeycomb—now often referred to as "kerion Celsi," encompassed a broad range of infantile dermatoses. This included the heavily encrusted seborrheic dermatitis, which used to be so universal in infancy that it acquired popular names such as "milk crust" or "crusta lactea." The condition was attributed to the milk which, like the blood of the mother or the nurse, supposedly contained corrupted humors that the suckling had to expel by way of the skin in accordance with the age-old humoral theory. His Contributions Hippocrates left us as his heritage a dermatological vocabulary, while Celsus bequeathed us clear clinical descriptions and many diagnoses. He considered chilblains to be sores produced by the cold in winter. He said they occur mostly in children, particularly on feet and toes and sometimes on the hands, producing redness, sometimes pustules followed by ulcerations, with moderate pain and more or less itching. At times, he continued, humor (fluid) exudes, but not much. This is an example of how he discussed selectively definite ailments in greater clinical detail than did Hippocrates. He described phyma, in which no core is found such as is found in a boil, but all the corrupted flesh is turned into pus. This occurs more often in children in whom it is more readily relieved. It is rare and more difficult to treat in young adults.
May 1976
Vol. 15
"Phygetron" is a similar swelling, not raised much, in which there is some resemblance to a pustule, with pain and tension as well as feverishness; not much pus is formed. It occurs particularly on the top of the head, or in the armpits or the groin. In other words, a cutaneous abscess of fair size in children belonged in the category of phyma, while phygetron seems to have designated cellulitis or a localized pyodermia. Further on, he discussed two kinds of kerion. It is the second kind which fits more closely the "cradle cap" of infants. However, Celsus did not specifically indicate that this was a disease of children. The matted hair and crusted, oozing inflammation of the adult lice-ridden scalp, infected with filth and by scratching, could fit the description just as well. However, later medical authors mentioned it specifically as a pediatric ailment. Celsus defined achrochordon as wartlike sores produced where some matter collects under the skin. It may be that he saw what we now call moUuscum, for he alluded to its common occanence in children in the form of clusters. He said the lesions were thin underneath, broadening nearer the skin, seldom larger than a bean, seldom single, and mostly found in children. Sometimes they disappear suddenly, sometimes they become purulent. Elsewhere,' he stated that children have a painful kind of warts the Greeks call acrochordones. If cut off, the acrochordon leaves no trace of a root behind and so does not sprout up again. He called the common wart thymion; others which he called myrmecia were a broader, deeper variety occurring especially on the hands and feet. "Areae Celsi" Regarding "areae Celsi," it should be noted that Celsus did not label these
No. 4
ANTIQUITY
alopecia. The Greeks called baldness alopecia which means "the fox disease," probably because foxes have patches of bald areas from the mange or from rubbing themselves to relieve itching. There is a saying that "no grass grows where the fox urinates," but it is unlikely that the disease owes Its name to this ancient shibboleth. Another name which the Greeks used for bald spots was ophiasis, the snake disease, possibly because of the serpentine outline and the way they spread; or perhaps because of the analogy seen in the way the snake periodically casts off its skin. Both alopecia and ophiasis were terms used to indicate scurfiness and desquamation and so were associated by later authors with conditions such as tinea tonsurans, impetigo and so on. "Area" in the time of Celsus referred to a threshing floor for grain which had a circular, smooth, glaring white surface—it was an apt descriptive term. Horace used the same word for a children's playground because the "area" or threshing floor was a fine place for some of the games children liked to play.^ Celsus spoke of two kinds of areae. Possibly he wanted to distinguish alopecia areata from ringworm of the scalp. Fracastor, about 1492, classified areae among the diseases causing infection by contact, using the word in the plural, like Celsus. In 1652 Johannes Johnston wrote about "capillorum areatum defluvium," areated falling-out of hair. In 1763 Sauvages adopted the modern term of alopecia areata, the first time it appeared in its entirety in the literature. Confused by Willan and Bateman with other forms of patchy loss of hair, the disease was also called porrigo deealvans. David Gruby, working in a Paris orphan asylum in 1842, discovered fungal parasites on the skin of the children, among which was Microsporon
Radbill
305
audoini. Bazin then named alopecia areata "le pelade," a term still in use in France. But both Gruby and Bazin did not realize that the circular patches they investigated on children's scalps that were caused by this fungus were not the same as the smooth and glaring white spots which Celsus called areae. It was Sabouraud who finally demonstrated clearly the specific connection between the microsporon and ringworm of the scalp. After that alopecia areata could be clearly separated from the latter. Other Conditions and Treatments Epinyctis, night sores, which Erasmus Wilson thought was analagous to pemphigus infantilis of Willan,'' was described by Celsus as a painful inflamed species of "pustule" about the size of a bean that came on principally at night and attacked even infants at the breast. In more recent times it was considered a form of nettlerash or urticaria, but I strongly suspect it was bedbug bites or the bites of some such unwelcome bedfellow of the night. What we used to call infantile eczema Celsus included in his general description of what he called "scabies," the scratching disease. This affects young as well as old without discrimination. He said the Greeks dubbed it psora agria, the fierce or savage scab. Among many other remedies, they recommended sulfur ointment for treatment when it was ulcerated. As for "impetigo," a term which long ago even included eczema in its various forms, Celsus had something wholly different in mind from the lesions we now designate impetigo, so frequently encountered in children. This term was derived from the sudden impetus with which the eruption struck. Vitiligo, derived from vitium (distemper), was a term he used to cover varieties of psoriasis. A white form he called
306
INTERNATIONAL lOURNAL OF DERMATOLOGY
alphos; a black form, melas. Leuce, somewhat like alphos but with fine hairs apparent, he said was not easily got rid of; I am not sure just what he had in mind. Birthmarks such as nevi which he said the Greeks called "semion" he thought were not as common as vari (pimples), lenticulas (moles) or ephelidas (freckles). These he considered insignificant. In treatment of all kinds of eruptions, Celsus recommended first exercise, then restricted diet. The patient was to avoid all thinned things and acrid, and the same dietary regimen was applied to nursing mothers if the suckling babe was affected. For pustules (Celsus usually meant any eruption when he wrote "pustules"), affecting infants, he recommended anointing them with cerussa (white lead) then smearing them with a mixture of pyrite stone (iron sulfide) mixed with bitter almonds. Many cases of lead poisoning must have gone unrecognized throughout the ages from this predilection for the use of topical lead. An occasional author casually noted this danger but little attention was paid to iatrogenic saturnism in children until well into the 20th century. They were aware that ingestion of lead was harmful, and for treating poisoning from swallowing it Celsus recommended mallow or walnut juice in wine as the best antidote.^ Kriton (about the first century AD) Cosmetics formed an important feature of medical practice in antiquity. In recent times this aspect of practice has been abandoned by the medical profession, leaving a vacuum willingly filled by beauticians. In the first century a remarkable work appeared on cosmetics by a little-known medical author, Kriton. (This may have been the same physician named Criton who was attendant of Emperor Trajan and who wrote a history
May 1976
Vol. 15
of the Dacian Wars.) Kriton covered in 4 books more than 50 subjects of dermatological interest ranging from axillary odors to psoriasis of the nails. He used magnificent names for his cosmetic preparations, like "incomparable remedv" and such. He told how to guard children against growing beards too early, for there was a time when hirsutism or hypertrichosis was considered bestial. 11 was this attitude that we find in the Bible where Esau, twin brother of Jacob, represented evil as Jacob was the symbol of good, for Esau was covered with hair all over as with a hairy garment. Kriton also told how to protect virginity, how to prevent pubic hair in girls not yet married since idyllically girls were often married off before puberty. Then there was advice concerning what to do for nits and for many skin blemishes affecting children. Pliny The Elder (32-79 A.D.) While Pliny was nol a physician, he did manage to pack a wealth of medical lore into his encyclopedia of natural history. This vast compilation of ancient folklore and science mentions that the Creeks went so far as to scrape the very filth off the walls of their public wrestling and gymnastic halls to use it in medical preparations. A similar product was used 1500 years earlier when we find the Egyptians, as recorded in the Ebers Papyrus, using fly dirt scraped from the walls as an ingredient of one of their medicines. Flies bred profusely and so were endowed with an active life principle which the ancients hoped could be transferred through their excreta much as vital force was transferred to the soil by fertilizing with animal manure. Pliny said the wall scrapings had a special excalfactory (heating) virtue in a sovereign liniment io heal ulcers on the bodies of children. In
No. 4
ANTIQUITY
this instance, the healing quality transmitted vitality through the perspiration of the athletes that collected on the walls, as Galen was to explain later. Pliny disclosed many other uses for such excrement.'' Elsewhere, he reported that it was believed a coin is an excellent remedy to cure sores on the heads of infants.'' This brings to mind the folk practice of curing disease by bribery or buying the disease, as it were. Discussing the virtues of an herb called maidenhair (adiantum), Pliny said "a good liniment is made thereof with oil rosat, to anoint young children that have the red gum and be all broken out: but first they should be bathed in wine."*' Actually, Pliny spoke of children having "ulcers," a general Latin word indicating any kind of sore or ulcer. His 17th century English translator changed this to "red gum," a term long common among English children's nurses for a papular red eruption of the skin in young infants. Willan refined this into strophulus intertinctus. Jasione (a kind of smooth bindweed) when applied to the heads of children, wrote Pliny, nourishes the hair and makes the skin more firm by closing the pores so that the hair is not shed easily and so is better retained. Apparently, it was expected to be not only a good fertilizer to promote growth of hair but a good fixation agent. On the other hand, walnut shells which were burnt, pulverized and incorporated with oil or wine was used to anoint heads of young babies to make the hair grow thick. For warts Pliny recommended turnsol, a species of heliotrope, saying the juice drawn out of the leaf mixed with salt
Radbill
307
takes away warts, wherefore herbalists call it in Latin verrucaria. Another kind, called scorpiurion, also causes warts to fall off by the very roots; and the leaves of a bitter herb which he called picris was likewise good to take away warts. Pliny recommended olive oil for the epinyctides which Philemon Holland in 17th century English called the "nightfoes or chillblains." The dregs or grounds of black olive oil were recommended for children to be applied as warm poultices. Translating Pliny, Holland wrote that oil of myrtle cures measles. He used the word "measles" in the same sense as Shakespeare, a term for any general rash synonymous with the word tetter. Measles then was not necessarily the measles of today; it was any "eruption," the word which Pliny actually used. Another condition which Pliny mentioned he called boa. It consisted of reddish papules. This, too, Holland translated as measles. Some historians tried to pin down "boa" as syphilis, but there is not enough evidence in Pliny for so specific a diagnosis. References 1. AllbuH, G., Greek Medicine in Rome. Londoji, 1921, pp. 25, 67. 2. Spencer, W. G., Gelsus De Medicina. Vol. 2. Gambridge, Harvard Universily Press, 19481953, p. 145. 3. Spencer, W. G., Gelsus De Medicina. Vol. 1. Gambridge, Harvard University Press. 4. Montgomery, D. W., Naming of alopecia areata. Ann. Med. Hist. 3:542, 1931. 5. Br. Med. J. 2:465, 1863. 6. Holland, P., The NatLiral Historie of G. Pliniu'; Secundus. Vol. 2. London, Islip, 1634, pp. 127, 303. 7. Ghinopoulo, S., Paediatrie in Flellas und Rom Fischer. Jena, 1930, p. 113.
PEDIATRIC DERMATOLOGY IN ANTIQUITY Part II. Roman Empire* SAMUEL X RADBILL, M.D. Honorary tibrarian. The College of Physicians of Philadelphia, Philadelphia, Pennsylvania
The Romans looked askance at doctors and doctoring. They depended on the Greeks for their medical lore. Nevertheless, several outstanding medical works appeared during the height of Imperial Rome which are classics and helped to advance medical science. The writings of Celsus, Pliny, Dioscorides, Soranus and Galen stand out in particular. Some inkling of dermatological conditions can also be discerned in the general literature of Rome. Thus, we learn from Plautus that in early Rome, which reeked with dirt, skin diseases were rife, since he affirmed that malignant ulcerations and eroding lesions spread among the people. Even cancer was known from earliest times. Cato (234-149 B.C.), mentioned it in his De Re Rustica and Ovid, contemporary of Celsus, aptly alluded to it by saying "and thus the incurable malignant cancer characteristically spreads far and wide."' We know that scabies was also widespread from the fact that in their efforts to protect themselves from illness the early Romans, who before they adopted Greek medicine worshipped innumerable gods of diseases, had among these a goddess of scabies. Greek medicine attacked the notion that there was a godling for every symptom, but the early Latins depended upon a troop of specializing gods to bring them health and good fortune. As there were gods for every ailment, so there were also doctors who specialized. There were those who
specialized in hernias, in fistulas, in the eyes, the ears and, dermatologically, there were doctors especially for the baths to which the Romans were so partial, and which were so essential a part of dermatological therapy. Up to the time of Cato, folk medicine used theurgy plus drugs; then the drugs gradually escaped from theurgy to attain the marvelous virtues of the Galenicals, which seemed scarcely less supernatural.' But scientific medicine came to Italy from the Greeks, and even Celsus, the first great compiler of medical knowledge, borrowed little from his own Latins. His treatise was wholly Greek in content. Yet, it was the first systematic medical treatise and had a great influence upon modern medicine. Wilh the invention of the printed text, it first appeared in print in 1478, 14 centuries after Celsus was gone, and has been reprinted at frequent intervals ever since.
Aurelius Cornelius Celsus (C.25 BC— c. 50 AD) Celsus lived about the time of Christ. Even though he was not a physician, he wrote a medical encyclopedia strikingly modern in concept and format, entirely free of sacerdotal or supernatural influences. Of particular interest to us here are the parts dealing with the skin that
* Part I appeared in |une 1975 14:363. Part III will appear in a future issue.
303
304
INTERNATIONAL JOURNAL OF DERMATOLOGY
are scattered throughout many sections of the work; chapter 28 of Book V is a full section devoted just to cutaneous inedicine." Here, among some 40 different dermatological conditions, we find many which are often encountered in infants and children. Indeed, even the well-known "area Celsi" (alopecia areata), occurs frequently in childhood. Favus, Latin for kerion—honeycomb—now often referred to as "kerion Celsi," encompassed a broad range of infantile dermatoses. This included the heavily encrusted seborrheic dermatitis, which used to be so universal in infancy that it acquired popular names such as "milk crust" or "crusta lactea." The condition was attributed to the milk which, like the blood of the mother or the nurse, supposedly contained corrupted humors that the suckling had to expel by way of the skin in accordance with the age-old humoral theory. His Contributions Hippocrates left us as his heritage a dermatological vocabulary, while Celsus bequeathed us clear clinical descriptions and many diagnoses. He considered chilblains to be sores produced by the cold in winter. He said they occur mostly in children, particularly on feet and toes and sometimes on the hands, producing redness, sometimes pustules followed by ulcerations, with moderate pain and more or less itching. At times, he continued, humor (fluid) exudes, but not much. This is an example of how he discussed selectively definite ailments in greater clinical detail than did Hippocrates. He described phyma, in which no core is found such as is found in a boil, but all the corrupted flesh is turned into pus. This occurs more often in children in whom it is more readily relieved. It is rare and more difficult to treat in young adults.
May 1976
Vol. 15
"Phygetron" is a similar swelling, not raised much, in which there is some resemblance to a pustule, with pain and tension as well as feverishness; not much pus is formed. It occurs particularly on the top of the head, or in the armpits or the groin. In other words, a cutaneous abscess of fair size in children belonged in the category of phyma, while phygetron seems to have designated cellulitis or a localized pyodermia. Further on, he discussed two kinds of kerion. It is the second kind which fits more closely the "cradle cap" of infants. However, Celsus did not specifically indicate that this was a disease of children. The matted hair and crusted, oozing inflammation of the adult lice-ridden scalp, infected with filth and by scratching, could fit the description just as well. However, later medical authors mentioned it specifically as a pediatric ailment. Celsus defined achrochordon as wartlike sores produced where some matter collects under the skin. It may be that he saw what we now call moUuscum, for he alluded to its common occanence in children in the form of clusters. He said the lesions were thin underneath, broadening nearer the skin, seldom larger than a bean, seldom single, and mostly found in children. Sometimes they disappear suddenly, sometimes they become purulent. Elsewhere,' he stated that children have a painful kind of warts the Greeks call acrochordones. If cut off, the acrochordon leaves no trace of a root behind and so does not sprout up again. He called the common wart thymion; others which he called myrmecia were a broader, deeper variety occurring especially on the hands and feet. "Areae Celsi" Regarding "areae Celsi," it should be noted that Celsus did not label these
No. 4
ANTIQUITY
alopecia. The Greeks called baldness alopecia which means "the fox disease," probably because foxes have patches of bald areas from the mange or from rubbing themselves to relieve itching. There is a saying that "no grass grows where the fox urinates," but it is unlikely that the disease owes Its name to this ancient shibboleth. Another name which the Greeks used for bald spots was ophiasis, the snake disease, possibly because of the serpentine outline and the way they spread; or perhaps because of the analogy seen in the way the snake periodically casts off its skin. Both alopecia and ophiasis were terms used to indicate scurfiness and desquamation and so were associated by later authors with conditions such as tinea tonsurans, impetigo and so on. "Area" in the time of Celsus referred to a threshing floor for grain which had a circular, smooth, glaring white surface—it was an apt descriptive term. Horace used the same word for a children's playground because the "area" or threshing floor was a fine place for some of the games children liked to play.^ Celsus spoke of two kinds of areae. Possibly he wanted to distinguish alopecia areata from ringworm of the scalp. Fracastor, about 1492, classified areae among the diseases causing infection by contact, using the word in the plural, like Celsus. In 1652 Johannes Johnston wrote about "capillorum areatum defluvium," areated falling-out of hair. In 1763 Sauvages adopted the modern term of alopecia areata, the first time it appeared in its entirety in the literature. Confused by Willan and Bateman with other forms of patchy loss of hair, the disease was also called porrigo deealvans. David Gruby, working in a Paris orphan asylum in 1842, discovered fungal parasites on the skin of the children, among which was Microsporon
Radbill
305
audoini. Bazin then named alopecia areata "le pelade," a term still in use in France. But both Gruby and Bazin did not realize that the circular patches they investigated on children's scalps that were caused by this fungus were not the same as the smooth and glaring white spots which Celsus called areae. It was Sabouraud who finally demonstrated clearly the specific connection between the microsporon and ringworm of the scalp. After that alopecia areata could be clearly separated from the latter. Other Conditions and Treatments Epinyctis, night sores, which Erasmus Wilson thought was analagous to pemphigus infantilis of Willan,'' was described by Celsus as a painful inflamed species of "pustule" about the size of a bean that came on principally at night and attacked even infants at the breast. In more recent times it was considered a form of nettlerash or urticaria, but I strongly suspect it was bedbug bites or the bites of some such unwelcome bedfellow of the night. What we used to call infantile eczema Celsus included in his general description of what he called "scabies," the scratching disease. This affects young as well as old without discrimination. He said the Greeks dubbed it psora agria, the fierce or savage scab. Among many other remedies, they recommended sulfur ointment for treatment when it was ulcerated. As for "impetigo," a term which long ago even included eczema in its various forms, Celsus had something wholly different in mind from the lesions we now designate impetigo, so frequently encountered in children. This term was derived from the sudden impetus with which the eruption struck. Vitiligo, derived from vitium (distemper), was a term he used to cover varieties of psoriasis. A white form he called
306
INTERNATIONAL lOURNAL OF DERMATOLOGY
alphos; a black form, melas. Leuce, somewhat like alphos but with fine hairs apparent, he said was not easily got rid of; I am not sure just what he had in mind. Birthmarks such as nevi which he said the Greeks called "semion" he thought were not as common as vari (pimples), lenticulas (moles) or ephelidas (freckles). These he considered insignificant. In treatment of all kinds of eruptions, Celsus recommended first exercise, then restricted diet. The patient was to avoid all thinned things and acrid, and the same dietary regimen was applied to nursing mothers if the suckling babe was affected. For pustules (Celsus usually meant any eruption when he wrote "pustules"), affecting infants, he recommended anointing them with cerussa (white lead) then smearing them with a mixture of pyrite stone (iron sulfide) mixed with bitter almonds. Many cases of lead poisoning must have gone unrecognized throughout the ages from this predilection for the use of topical lead. An occasional author casually noted this danger but little attention was paid to iatrogenic saturnism in children until well into the 20th century. They were aware that ingestion of lead was harmful, and for treating poisoning from swallowing it Celsus recommended mallow or walnut juice in wine as the best antidote.^ Kriton (about the first century AD) Cosmetics formed an important feature of medical practice in antiquity. In recent times this aspect of practice has been abandoned by the medical profession, leaving a vacuum willingly filled by beauticians. In the first century a remarkable work appeared on cosmetics by a little-known medical author, Kriton. (This may have been the same physician named Criton who was attendant of Emperor Trajan and who wrote a history
May 1976
Vol. 15
of the Dacian Wars.) Kriton covered in 4 books more than 50 subjects of dermatological interest ranging from axillary odors to psoriasis of the nails. He used magnificent names for his cosmetic preparations, like "incomparable remedv" and such. He told how to guard children against growing beards too early, for there was a time when hirsutism or hypertrichosis was considered bestial. 11 was this attitude that we find in the Bible where Esau, twin brother of Jacob, represented evil as Jacob was the symbol of good, for Esau was covered with hair all over as with a hairy garment. Kriton also told how to protect virginity, how to prevent pubic hair in girls not yet married since idyllically girls were often married off before puberty. Then there was advice concerning what to do for nits and for many skin blemishes affecting children. Pliny The Elder (32-79 A.D.) While Pliny was nol a physician, he did manage to pack a wealth of medical lore into his encyclopedia of natural history. This vast compilation of ancient folklore and science mentions that the Creeks went so far as to scrape the very filth off the walls of their public wrestling and gymnastic halls to use it in medical preparations. A similar product was used 1500 years earlier when we find the Egyptians, as recorded in the Ebers Papyrus, using fly dirt scraped from the walls as an ingredient of one of their medicines. Flies bred profusely and so were endowed with an active life principle which the ancients hoped could be transferred through their excreta much as vital force was transferred to the soil by fertilizing with animal manure. Pliny said the wall scrapings had a special excalfactory (heating) virtue in a sovereign liniment io heal ulcers on the bodies of children. In
No. 4
ANTIQUITY
this instance, the healing quality transmitted vitality through the perspiration of the athletes that collected on the walls, as Galen was to explain later. Pliny disclosed many other uses for such excrement.'' Elsewhere, he reported that it was believed a coin is an excellent remedy to cure sores on the heads of infants.'' This brings to mind the folk practice of curing disease by bribery or buying the disease, as it were. Discussing the virtues of an herb called maidenhair (adiantum), Pliny said "a good liniment is made thereof with oil rosat, to anoint young children that have the red gum and be all broken out: but first they should be bathed in wine."*' Actually, Pliny spoke of children having "ulcers," a general Latin word indicating any kind of sore or ulcer. His 17th century English translator changed this to "red gum," a term long common among English children's nurses for a papular red eruption of the skin in young infants. Willan refined this into strophulus intertinctus. Jasione (a kind of smooth bindweed) when applied to the heads of children, wrote Pliny, nourishes the hair and makes the skin more firm by closing the pores so that the hair is not shed easily and so is better retained. Apparently, it was expected to be not only a good fertilizer to promote growth of hair but a good fixation agent. On the other hand, walnut shells which were burnt, pulverized and incorporated with oil or wine was used to anoint heads of young babies to make the hair grow thick. For warts Pliny recommended turnsol, a species of heliotrope, saying the juice drawn out of the leaf mixed with salt
Radbill
307
takes away warts, wherefore herbalists call it in Latin verrucaria. Another kind, called scorpiurion, also causes warts to fall off by the very roots; and the leaves of a bitter herb which he called picris was likewise good to take away warts. Pliny recommended olive oil for the epinyctides which Philemon Holland in 17th century English called the "nightfoes or chillblains." The dregs or grounds of black olive oil were recommended for children to be applied as warm poultices. Translating Pliny, Holland wrote that oil of myrtle cures measles. He used the word "measles" in the same sense as Shakespeare, a term for any general rash synonymous with the word tetter. Measles then was not necessarily the measles of today; it was any "eruption," the word which Pliny actually used. Another condition which Pliny mentioned he called boa. It consisted of reddish papules. This, too, Holland translated as measles. Some historians tried to pin down "boa" as syphilis, but there is not enough evidence in Pliny for so specific a diagnosis. References 1. AllbuH, G., Greek Medicine in Rome. Londoji, 1921, pp. 25, 67. 2. Spencer, W. G., Gelsus De Medicina. Vol. 2. Gambridge, Harvard Universily Press, 19481953, p. 145. 3. Spencer, W. G., Gelsus De Medicina. Vol. 1. Gambridge, Harvard University Press. 4. Montgomery, D. W., Naming of alopecia areata. Ann. Med. Hist. 3:542, 1931. 5. Br. Med. J. 2:465, 1863. 6. Holland, P., The NatLiral Historie of G. Pliniu'; Secundus. Vol. 2. London, Islip, 1634, pp. 127, 303. 7. Ghinopoulo, S., Paediatrie in Flellas und Rom Fischer. Jena, 1930, p. 113.
